Class 1 Flashcards
Jeanne Prentice
Active CNM (certified nurse midwife) A Nurse Midwife, she led the initiative to allow women to give birth at home.
Led the initiative called “PUSH!” The aim was to allow Certified Nurse Midwives to attend home births.
She ensured that home births become not only possible, but a safe and viable option.
Mary Breckinridge (1881-1965) - In 1925
Introduced modern rural health care system in the United States.
Called the Frontier Nursing Service (FNS), provided professional medical services to population in rural southeastern Kentucky.
The (FNS) used nurse-midwives, district nursing centers, and hospital facilities to ensure no patient was more than 6 miles away from a nurse-midwife in this 1000-square mile region.
Helen Fairchild (November 21, 1885 – January 18, 1918)
An American nurse who served as part of the American Expeditionary Force during World War I.
She had a very short career as a nurse, (died at 32 years old), but was known for her wartime letters to her family in the U.S., which vividly depicted combat nursing during World War I.
Florence Nightingale Crimean War (1853)
1860-First organized nursing program. (London)
Cleanliness improved illness
Florence “lady with the lamp”
Sanitation, nutrition, facilities were poor.
Tasked with organizing and improving sanitation of facilities.
Mortality reduced from 42.7% to 2.2% in 6 months.
2.5 year conflict claimed at least 750,000 lives.
Clara Barton (1821–1912) Civil War (1860-1865)
“Angel of the Battlefield”. Declined a salary for caring for soldiers.
Founder of American Red Cross
Mary Mahoney
First black woman to complete nurse’s training in the U.S (1879, MA)
Devoted to private duty nursing for most of her 30-year career.
She was very active in fighting for women’s equality.
She was one of the first women to register to vote in 1920
Lillian Wald & Mary Brewster
Henry Street Settlement (1893)
Opened a health clinic for the poor that lived in tenements in NYC.
Significant increase in community nursing.
First Public Health Nursing
Dorothea Dix
Responsible for better working conditions for nurses and hospital conditions for soldiers..
Stipulated that only plain-looking women over 30 be employed in order to avoid stereotypes of nurses.
Fought for the rights of the mentally ill
Superintendent of female nurses Union Army
When was The American Nurses Association (ANA) established
1896
The American Nurses Association (ANA) services provided?
Preadmission and achievement tests for nursing students.
Statistical data on nursing personnel and trends in health care delivery.
NLNAC, accreditation of nursing education schools and programs. (National League for nursing Accrediting commision)
The testing service for the State Board Exams for registered and practical nurse licensure.
The Research Division and Public Affairs Office are other sections of NLN. (National League for Nursing)
Nursing Education Perspectives, publication of the organization
The TJC National Patient Safety Goals
are?
what does TJC stand for?
Purpose: To improve patient safety.
Goals: Focus on problems in health care safety and how to solve them.
TJC: The Joint Commission
Identify Patients correctly
Improve staff communication: test results to right staff, on time.
Use medication safely
Use alarms safely
Prevent infection
Hand washing/disinfection, central lines, surgical infections, urinary catheters.
Identify patient safety risks
Find out which patients are most likely to try to commit suicide
Prevent mistakes in surgery
Nursing Professional responsibilities?
Care and comfort
Health promotion
Illness prevention
Disease and symptom management
Family support
End-of-life care
Nursing Roles?
Autonomy-initiation of nursing interventions without medical orders. (C & DB)
Accountability-responsible professionally and legally for care provided.
Caregiver
Advocate
Protect the patient’s human and legal rights
Educator
Communicator
Manager (Leader)
Patricia Benner’s Model
Novice
Beginner has no experience in the situations in which they are expected to perform
Lacks confidence.
Patricia Benner’s Model
Advanced Beginner
Demonstrate marginally acceptable performance due to prior experience.
Efficient and skillful in parts of the practice
Knowledge is developing.
Patricia Benner’s Model
Competent
On the job in the same or similar setting for 2-3 years.
Demonstrate efficiency, is coordinated and confident.
Deliberate planning, efficiency, and organization is characteristic of this skill level.
Care is completed within a suitable time frame without supporting cues
Patricia Benner’s Model
Proficient
Perceives situations as whole in terms of long-term goals.
Learns from experience what typical events to expect and how to modify in response to these events.
Organized and prioritizes holistic care.
Patricia Benner’s Model
Expert
Has intuition zeroes in on the problem.
Operates from a deep understanding of the total situation.
Performance becomes fluid and flexible and highly proficient.
Analytic ability for situations the nurse has no previous experience.
Trends in Healthcare
Holistic focus
Maintaining Health
Care during Illness
Interaction with the family and community
Increasing awareness for patient safety in all care settings
Trends in Healthcare
Nursing Shortages Offer Opportunities
> 50% of working nurses are over 50. Positions to fill as they retire.
Millennial nurses will be more ethnically diverse and tech-savvy.
Need to prepare for different cultures, religions and languages.
Trends in Healthcare
Job Opportunities Expand Outside the Hospital
Nurses will play a much bigger role in communities outside hospitals and other health care facilities. (Elderly prefer home to LTC)
Need for nurses in chronic care, geriatrics, palliative and hospice care.
Trends in Healthcare
Technology Will Play a Larger Role
Simulation in school and work place.
Electronic medical record expansion.
Levels of Health Care Services
Ambulatory care
Primary Care offices and outpatient clinics
Levels of Health Care Services
Acute care
Hospital inpatient care: 24 hour care
Surgical Care Centers
Levels of Health Care Services
Tertiary care
Intensive care
Regional medical centers
Subacute care (LTAC)
Levels of Health Care Services
Restorative Care
Cardiovascular and pulmonary rehab
Sports medicine
Spinal cord injury programs
Home care
Levels of Health Care Services
Continuing Care
Assisted living
Long term Care
Psychiatric and older adult day care
End of Life Care / Hospice
Primary Prevention Care meaning and examples
Precedes illness or disease. Reducing risks to health for an entire population. Nutrition Immunizations Prenatal care Well baby check ups Exercise classes
Secondary Preventive Care meaning and examples
focus on early detection and treatment.
Blood pressure screenings
Mental health counseling/crisis prevention
Government laws (seat belts, air bags, bike helmets, etc.)
Tertiary prevention meaning and examples
Reduce the impact of an ongoing illness or injury that has lasting effects.
Chronic disease management programs (diabetes, arthritis, depression, etc.)
Rehabilitation programs for cardiac and pulmonary diseases.
Support groups that allow members to share strategies for living well
What is QSEN?
Quality and Safety Education for Nurses
The Robert Woods Johnson Foundation sponsored the initiative
What is IOM?
Institute of Medicine
Response to safety and quality patient care reports by IOM
Patient-Centered care
Teamwork
Collaboration
Evidence-based practice
Quality improvement
Safety
Prevention of errors and minimize risk of harm.
Informatics
Electronic Medical Record
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Hildegard Peplau’s Theory 4 phases of the nurse-patient relationship
Preorientation: data gathering
Orientation: Defining problems
Working phase: Therapeutic activity
Resolution: Termination of the relationship
Hildegard Peplau’s Theory
Interpersonal Relations Theory
MA in psychiatric nursing (1909-1999 USA)
The mother of psychiatric nursing
Focus on interpersonal relations among a nurse, a patient, and patient’s family.
Develop therapeutic relationships with patients that are respectful, empathetic, and non judgmental.
Madeleine Leininger’s Theory
Transcultural Care Theory (Sunrise/Sunshine Model)
Human caring varies among cultures in expression, processes and patterns.
Goal: Nurses to provide culturally specific nursing care.
Health beliefs, role of the family and community, and dietary practices.
Madeleine Leininger’s Theory examples
Religious beliefs
Religious leader may visit
Last rights
Dietary
No pork for Muslims
Vegan diets
Jehovah Witness-No blood products
What is IRB
Institutional Review Board
IRB Functions
Research involving human participants must be reviewed and approved by an Institutional Review Board (IRB).
Provide guidance and oversight for the human participant protection program and for helping to maintain compliance with applicable laws, regulations, and policies.
Require that information given to participants as part of informed consent
6 Occupational Risks
Biologic: exposure to contagious and infectious diseases
Chemical: Anesthetic gases, medications, Latex (in gloves and equipment)
Ergonomic: Physical demands involve force, repetition, awkward postures and prolonged activities.
Physical: Exposure to radiation: both x-rays and radiation from radioisotopes.
Safety: Needle sticks, combative patients, slip on wet floors.
Psychological: Responsibility of care, emergencies, and the need to make certain decisions. Exposure to serious traumatic events. Long hours/work schedules can have health effects
Evidence based practice definition
A problem-solving approach to clinical practice that integrates the best evidence in combination with a clinician’s expertise and patient preferences and values in decisions regarding healthcare.
Benefits of EBP
Improves quality, safety, patient outcomes and nurse satisfaction while reducing costs.
List the 7 steps of EBP
Spirit of inquiry: Identify the problem
Ask a clinical question in PICOT format (p. 54 box 5-1)
Search for the evidence.
Critique the evidence gathered.
Integrate evidence with your clinical expertise and patient preference and values.
Evaluate the outcomes of practice decisions or changes using the evidence.
Share the outcomes of the EBP changes with others.
PICOT
P- patient population of interest. ie: identify patient by age, gender, ethnicity, disease/health problem
I- intervention of interest. ie: which intervention is worthwhile to use in practice. treatments, diagnostic test/factor
C- comparison of interest. ie: what is usual standard of care or current intervention used now
O- outcome. ie: what results do you wish to achieve/observe as result of an intervention. change in patients behavior, physical findings or patient perception
T- time. ie: what amount of time is needed for intervention to achieve an outcome. the amount of time needed to change quality of life
Nursing Research
-Baccalaureate programs
have a basic understanding of the processes of research and apply research findings from nursing and other disciplines in their clinical practice
Nursing Research
-Master’s programs
evaluate research findings and develop and implement evidence-based practice guidelines
Nursing Research
- Practice focused doctoral programs
Focus on the evaluation and use of research rather than the conduct of research
Nursing Research
-Research focused doctoral programs
Plan and launch an independent program of research, seek needed support for initial phases of the research program and begin to involve other (students, clinicians and other researchers) in that work
